| Avon Dental P.c. | |
|
23 W Rollins Rd Round Lake Beach IL 60073-1350 | |
| (847) 740-4600 | |
| Not Available |
| Full Name | Avon Dental P.c. |
|---|---|
| Speciality | Dentist |
| Location | 23 W Rollins Rd, Round Lake Beach, Illinois |
| Authorized Official Name and Position | Siddharth Bansal (SECRETARY) |
| Authorized Official Contact | 3528728066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avon Dental P.c. 1460 S Peoria St Chicago IL 60608-2208 Ph: (352) 872-8066 | Avon Dental P.c. 23 W Rollins Rd Round Lake Beach IL 60073-1350 Ph: (847) 740-4600 |
| NPI Number | 1588086946 |
|---|---|
| Provider Enumeration Date | 01/19/2014 |
| Last Update Date | 01/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588086946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019028736 (Illinois) | Primary |
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